Movement Disorders

Movement disorders are a group of conditions characterized by alteration in normal motility, posture or tone, alone or in combination. Changes caused by motor paralysis, severe sensory loss, painful syndromes or skeletal deformities, etc. are not included in these disorders. Though movement abnormalities may be seen with lesions of the cerebral hemispheres, cerebellum, and brainstem or in metabolic disorders, the most common site is the extrapyramidal system (basal ganglia). This is a phylogenetic ally older motor system and is responsible for regulation of tone, automatic movements and posture. The basal ganglia cannot produce fine voluntary movement in man, which is a function of the pyramidal system. The extrapyramidal system “sets the background for efficient functioning of the pyramidal system”. The manifestation of an extrapyramidal lesion depends on the role of a given part within the overall organization of the system. Whereas lesions of the substantial-nigra often produce typical Parkinsonism (with tremor, bradykinesia and rigidity), akinetic-rigid Parkinsonism may be produced by lesions of the globus pallidus. Focal lesions in the caudate can produce chorea, while lesions in the putamen may cause dystonia. The clinical findings will be contralateral to the side of the lesion. Movement disorder manifestations are characterized as either hyperkinetic (increased movement) or hypokinetic (decreased movement). Hyperkinetic movement disorders include tremor, chorea, ballismus, athetosis, myoclonus, tics, and dyskinesia’s. Parkinsonism is a hypokinetic movement disorder, with overall paucity of movement, with the exception of tremor (hyperkinesia). Dystonia is also a combination of hypokinesis and hyperkinesis, with the dominant picture of increased tone caused by agonist and antagonist co-contraction with rare dystonic tremor is focused in Neuro Forum 2020 to lead a better life.